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Gastroenterology Research and Practice
Volume 2013 (2013), Article ID 730829, 6 pages
http://dx.doi.org/10.1155/2013/730829
Research Article

Negative Pressure Wound Therapy for the Treatment of the Open Abdomen and Incidence of Enteral Fistulas: A Retrospective Bicentre Analysis

1Department of General, Visceral and Vascular Surgery, Fürst-Stirum-Klinik, 76646 Bruchsal, Germany
2Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital of Saarland, 66421 Homburg, Germany
3Department of General and Visceral Surgery, Barmherzige Brüder Hospital, 80639 Munich, Germany

Received 5 June 2013; Accepted 6 September 2013

Academic Editor: Rao R. Ivatury

Copyright © 2013 Sven Richter et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The open abdomen (OA) is often associated with complications. It has been hypothesized that negative pressure wound therapy (NPWT) in the treatment of OA may provoke enteral fistulas. Therefore, we analyzed patients with OA and NPWT with special regard to the occurrence of intestinal fistulas. Methods. The present study included all consecutive patients with OA treated with NWPT from April 2010 to August 2011 in two hospitals. Patients’ demographics, indications for OA, risk factors, complications, outcome and incidence of fistulas before, during and after NPWT were recorded. Results. Of 81 patients with OA, 26 had pre-existing fistulas and 55 were free from a fistula at the beginning of NPWT. Nine of the 55 patients developed fistulas during ( ) or after NPWT ( ). Seventy-five patients received ABThera therapy, 6 patients other temporary abdominal closure devices. Only diverticulitis seemed to be a significant predisposing factor for fistulas. Mortality was slightly lower for patients without fistulas. Conclusion. The present study revealed no correlation between occurrence of fistulas before, during, and after NWPT, with diverticulitis being the only risk factor. Fistula formation during NPWT was comparable to reports from literature. Prospective studies are mandatory to clarify the impact of NPWT on fistula formation.